| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP BENEFIT ADMINISTRATORS OF CT3 | 23 MAIDEN LANE NORTH HAVEN, CT 06473 | ANTHEM LIFE INSURANCE COMPANY | $2K | — | $2K | 1.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRI STATE JOINT FUND EIN 06-0850110 AFFILIATED ORGANIZATION | Claims processing; Direct payment from the plan Service code 12 | — | $347K |
| ANTHEM BLUE CROSS BLUE SHIELD EIN 06-1475928 NONE | Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue Service code 12 | — | $234K |
| FUND MANAGER EIN 04-2589472 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $87K |
| CLAIMS PROCESSOR EIN 04-2589472 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $84K |
| MANNING & NAPIER ADVISORS, INC EIN 45-3240790 NONE | Investment management; Investment management fees paid indirectly by plan; Investment management fees paid directly by plan Service code 28 | 290 WOODCLIFF DRIVE FAIRPORT, NY 14450 | $64K |
| HAMLIN CAPITAL MANAGEMENT LLC EIN 52-2344187 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 640 FIFTH AVENUE 6TH FLOOR NEW YORK, NY 10019 | $58K |
| MAINTENANCE EIN 04-2589472 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $53K |
| RAYMOND JAMES ASSOCIATES INC EIN 59-1237041 NONE | Other fees; Investment advisory (plan); Custodial (securities); Account maintenance fees; Investment management fees paid directly by plan Service code 19 | — | $40K |
| MED CARE MANAGEMENT INC EIN 88-0429522 NONE | Other services; Other fees Service code 49 | — | $36K |
| HMC HEALTHWORKS INC EIN 75-3189468 NONE | Other fees; Other services Service code 49 | — | $26K |
| PREFERRED ACCESS NETWORK EIN 36-4018433 NONE | Other fees; Other services Service code 49 | — | $26K |
| DHK FINANCIAL ADVISORS INC EIN 02-0464577 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $25K |
| WINSLOW, EVANS & CROCKER, INC EIN 04-3144652 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 175 FEDERAL STREET BOSTON, MA 02110 | $21K |
| MILLER HOWARD INVESTMENTS INC EIN 14-1710657 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | 324 UPPER BYRDCLIFFE RD WOODSTOCK, NY 12498 | $18K |
| RHUMBLINE ADVISORS EIN 04-3076646 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | 265 FRANKLIN STREET 21ST FLOOR BOSTON, MA 02110 | $15K |
| ALLEGIANT RX EIN 02-6015031 NONE | Other fees; Consulting (general); Contract Administrator Service code 13 | 91 GOFFSTOWN ROAD MANCHESTER, NH 03102 | $12K |
| CHARLES SCHWAB EIN 42-1558009 NONE | Other fees; Custodial (securities); Direct payment from the plan Service code 19 | 211 MAIN STREET SAN FRANCISCO, CA 94105 | $11K |
| EXETER TRUST COMPANY EIN 02-0476209 NONE | Direct payment from the plan; Other fees; Custodial (securities); Account maintenance fees Service code 19 | 290 WOODCLIFF DRIVE FAIRPORT, NY 14450 | $8K |
| VICTOR SANTIAGO EIN 04-2589472 UNION TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $6K |
| DAVIS VISION EIN 11-3051991 NONE | Other fees; Other services Service code 49 | — | $6K |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 NONE | Other services; Other fees Service code 49 | — | $5K |
| MPL LLC EIN 06-1537302 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | — | $0 |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 664 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 61 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 676 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,401 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 676 | $86K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 676 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 676 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.